A pediatric emergency medicine physician reveals the symptoms you should be watching for—and the four viruses responsible.
As the classic holiday song goes, “It’s the most wonderful time of the year.” But for healthcare workers running the country’s emergency rooms, it’s also unfortunately one of the busiest, thanks in part to a potentially dangerous spike in viral illnesses among children.
Meghan Beach Martin, MD, an emergency medicine physician at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida, recently posted a video on her social media accounts in which she shared four viral illnesses “wreaking absolute havoc” on children’s health right now. Dr. Martin, who is better known to her millions of online followers as @Dr.Beachgem10, says that respiratory syncytial virus, most commonly known as RSV, is currently tearing through pediatric emergency rooms, making it the number one virus she’s treated recently.
“We were seeing a little bit of it [before], but it is definitely here now,” the doctor told her followers in the November 28 video. “It’s mostly younger infants and toddlers—the older kids typically have some underlying asthma or breathing problem.”
Dr. Martin says that common symptoms of RSV include cough, wheezing, fever, vomiting, and diarrhea. “They just look terrible,” she says of the children she treats. “We do a lot of suctioning, but they’re still coughing, gagging on all of that mucus. We’re having to admit a lot of the kids, which means the hospital is starting to get busier.”
The doctor’s experience aligns with broader trends. According to the U.S. Centers for Disease Control and Prevention (CDC), RSV “is the most common cause of severe respiratory illness in young children,” and typically peaks in December and January.
However, that’s not the only ailment currently prompting worried caregivers to bring children to the hospital. Dr. Martin adds three additional viruses to her top-four list.
The flu—specifically influenza A—is one of the viruses on the doctor’s radar. “These kids are also really miserable. They look terrible,” she says, noting that the illness can last for four to seven days. Common symptoms include cough, fever, runny nose, fever, aches, vomiting, diarrhea, and fatigue. On top of that, “they’re just puny, so we’re having to give a lot of fluids,” Dr. Martin explains. “We’re seeing a little bit of myositis—which is really bad leg pain—so they don’t want to walk. We’re checking some labs for those usually. These kids are not feeling well.”
Importantly, Dr. Martin says that so far this season, she hasn’t treated a single case of the flu in which the child had been vaccinated—or a single case of RSV where either the mother had received the vaccination or the child had been given monoclonal antibodies. “There will be breakthrough cases… it’s still pretty early in the season,” she admits—but emphasizes that these vaccines remain a best defense against the season’s worst viruses.
In Dr. Martin’s number three spot is rhinovirus and enterovirus, which she describes as “a family of viruses that can do lots of different things.” She says these viruses are most often associated with respiratory symptoms, including cough, wheezing, and difficulty breathing, but can also include runny nose, fever, and more. Cases that land kids in the ER typically present with bronchiolitis—an infection in the small airway in the lungs, she says, adding: “They’re needing some respiratory support.”
“Number four is croup, most likely parainfluenza virus,” says the doctor, who is also a mother of four herself. “This makes kids have a cough, a little bit of a runny nose, and they wake up in the middle of the night absolutely short of breath, barking. It’s super scary but by the time you get to the hospital most of them are doing better,” she adds. “We’ll give a dose of steroids or sometimes they’ll need a special breathing treatment called racemic epinephrine. We’ve been seeing a lot of these.”
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